Future Treatments for Multiple Myeloma

In the Pipeline and Under Study

As part of the Roswell Park mission to cure cancers of all kinds, we place a high priority on providing more treatment options for patients, to give them a better chance against their disease than just the current standard of care. All of our physicians in the Lymphoma and Myeloma Team are also scientists who are actively engaged in clinical and laboratory research.

From the Lab to the Clinic

Translational research speeds the transfer of discoveries from the lab to the clinic so patients will benefit sooner. Studies of treatments that show great promise in the lab undergo intensive review by the FDA before they are approved for use in clinical research studies that will evaluate how well they work in patients.

Because Roswell Park is a comprehensive cancer center, eligible multiple myeloma patients who are treated here have access to clinical trials of treatments that would not be available at most other treatment centers.

Target: Myeloma

Our current strategies in the development of new multiple myeloma treatments focus on: 

  • The discovery of new targets or pathways to shut down multiple myeloma at the molecular level.
  • Understanding how the environment in the bone marrow supports the growth of multiple myeloma and finding ways to disable that support.
  • Determining the best timing for eligible patients to undergo BMT.
  • Determining the best BMT treatment approach for patients who are eligible for transplant.

Roswell Park researchers were among the first to recognize that multiple myeloma can be attacked effectively with treatments that disrupt the microenvironment that nurtures the myeloma cells. By developing new treatments that focus on the immune system and the microenvironment rather than the cancer cell itself, we hope to improve survival rates and spare patients the side effects of chemotherapy. Specifically, we are trying to better understand the interaction between myeloma cells and the bone marrow environment, so we can develop a more powerful way to attack myeloma cells — not directly, but through the soil in which they grow.

Kelvin Lee, MD, Chair of the Department of Immunology and The Jacobs Family Chair in Immunology at Roswell Park, led a team that provided the first evidence that a specific cell surface receptor called CD28 is absolutely necessary for myeloma cells to survive. Our investigators are now studying novel treatment strategies that block the interaction between the CD28 receptor on multiple myeloma cells and the cells in the bone marrow microenvironment that help the cells grow. The goal: to kill cancerous plasma cells and make the remaining cells more vulnerable to chemotherapy.

Dr. Lee is also developing new strategies for vaccine therapy against multiple myeloma, using novel vaccines developed and clinically tested by Roswell Park’s Center for Immunotherapy. The vaccines are combined with small-molecule drugs that can wake up the immune system so it will recognize the myeloma cells as harmful and destroy them.

Other research focuses on autologous stem cell transplant, which is commonly used to treat multiple myeloma. Hong Liu, MD, PhD, a member of the Multiple Myeloma team, is Principal Investigator at Roswell Park of a multi-center effort to find ways to improve transplant outcomes, via a clinical research study (clinical trial) comparing three different transplant methods. Long-term follow-up of transplant patients enrolled on the study will help identify the factors associated with longer remission.

Dr. Liu is also Principal Investigator at Roswell Park of a non-therapeutic (non-treatment) clinical study that will create a database of information about multiple myeloma patients who develop osteonecrosis of the jaw (ONJ). Though rare, ONJ can occur in multiple myeloma patients who receive bone-building drugs called bisphosphonates to rebuild bone that the disease has eroded. Unfortunately, in rare cases, the bisphosphonates can eventually cause ONJ, a painful condition in which the jawbone begins to die because blood circulation is cut off. The ONJ Case Registry will provide researchers will a useful tool for identifying the factors that lead to ONJ so we can learn how to prevent it or treat it more effectively.